Pulpal calcification: A systematic review and meta-analysis evaluating differences among repair materials and the association with vital pulpal therapy success.

Authors

Victor Santos Dos Santos, Patrícia Maria Poli Kopper, Rafaella Ronchi Zinelli, Roberta Kochenborger Scarparo

Published in

Journal of the American Dental Association (1939). Aug 06, 2026. Epub Aug 06, 2026.

Abstract

Vital pulpal therapy (VPT) failure associated with pulpal calcifications (PCs) may represent technical challenges for root canal treatment. The authors aimed to assess the PC rate after VPT using different repair materials (RMs) and to verify the association between PC and treatment success.
Six databases were searched for studies published from inception through May 1, 2025. The PC rate using different RMs and the association between PC and VPT success were collected for qualitative and quantitative synthesis. Meta-analyses were performed to verify differences in PCs according to the RMs and to compare success rates according to the presence of PCs. Using Version 2 of the Cochrane risk of bias tool for randomized trials and the Risk of Bias in Non-Randomized Studies of Interventions, Version 2, the authors assessed the risk of bias for randomized clinical trials and nonrandomized intervention studies, respectively. The authors assessed the certainty of evidence using the Grading of Recommendations, Assessment, Development and Evaluation approach.
Forty-two studies were selected for qualitative synthesis and 37 were selected for meta-analysis. PCs occurred in 8.80% of the teeth, with a 96.77% success rate in obliterated canals. PC was not associated with VPT success (odds ratio, 1.01; 95% CI, 0.43 to 2.38). No significant differences were found in PC rates of mineral trioxide aggregate compared with other RMs (odds ratio, 1.91; 95% CI, 0.84 to 4.33). Risk of bias was moderate to low in randomized clinical trials and moderate in nonrandomized intervention studies. The certainty of the evidence was high for the comparison of RMs and very low for the impact of PCs on VPT success.
After VPT, the PC rate was low and comparable among RMs. PC does not influence VPT success. Therefore, VPT contraindication due to the risk of developing a failure associated with PC cannot be considered an evidence-based practice.

PMID:
42560292
Bibliographic data and abstract were imported from PubMed on 06 Aug 2026.

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